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脊柱手术后突发无痛性视力丧失:在黑暗中吸取的教训。

Sudden painless loss of vision following spine surgery: lessons learnt in darkness.

机构信息

Institute of Orthopaedics & Traumatology, Madras Medical College, Chennai, Tamil Nadu, India.

Government Hospital, Velayuthampalayam, Karur, Tamil Nadu, India

出版信息

BMJ Case Rep. 2021 Jan 18;14(1):e235888. doi: 10.1136/bcr-2020-235888.

Abstract

A 26-year-old male driver presented with a history of pain in the neck for the past 1 week following trauma due to a road traffic accident. The patient had no neurological deficit. He had type 1 diabetes and was on regular oral hypoglycemics. After radiological investigations, the patient was diagnosed to have traumatic AO Spine Classification type C translational injury involving anterolisthesis of C6 over C7. After a detailed preoperative assessment, the patient was taken up for surgery. The patient underwent posterior stabilisation with instrumentation from C5 to T2. On extubation from anaesthesia, he immediately complained of complete painless loss of this vision in his left eye. Ophthalmological investigations attributed the cause to be due to central retinal artery occlusion. The patient was discharged with reassurance on the 20th postoperative day with minimal improvement in his vision and at 6-month follow-up, his vision improved to 1/60 and was advised for close follow-up.

摘要

一位 26 岁男性司机因道路交通事故受伤后,颈部疼痛已有一周。患者无神经功能缺损。他患有 1 型糖尿病,正在服用常规口服降糖药。经过影像学检查,患者被诊断为创伤性 AO 脊柱分类 C 型平移损伤,涉及 C6 在 C7 上的前滑。经过详细的术前评估,患者接受了手术治疗。患者行 C5 至 T2 的后路稳定化和器械固定。从麻醉中拔出气管插管后,他立即主诉左眼无痛性完全失明。眼科检查将病因归因于视网膜中央动脉阻塞。患者在术后第 20 天出院,视力有轻微改善,在 6 个月的随访中,他的视力提高到 1/60,并建议密切随访。

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